A Population-Based Study of Breast Cancer-Specific Survival Following Mastectomy and Immediate or Early-Delayed Breast Reconstruction
The Breast Journal, 04/09/2012
Agarwal J et al. – The analysis shows that patients who undergo breast reconstruction after mastectomy have a higher breast cancer–specific survival than those undergoing mastectomy alone, when controlling for demographic and oncologic covariates. Further research is required to understand the nature of this relationship.Methods
- Population–level de–identified data was abstracted from the SEER database.
- All female patients treated with mastectomy for a diagnosis of ductal and/or lobular breast cancer between 1998 and 2002 were included.
- Breast cancer–specific survival was reported as hazard ratios using multivariate analysis to control for patient demographic and oncologic covariates.
- Demographic covariates included age, race, marital status, income, education, and county metropolitan status; oncologic covariates included tumor stage, histology, grade, lymph node status, hormone receptor status, receipt of radiation therapy, and unilateral or bilateral mastectomy.
- A total of 52,249 patients were included in the study.
- Patients treated with mastectomy and reconstruction had a significantly lower hazard of death (HR 0.73, p < 0.0001) compared with patients treated with mastectomy only.
- Black patients had a significantly increased hazard of death (HR 1.42, p < 0.0001) compared with white patients.
- Receipt of radiotherapy did not significantly associate with hazard of death (HR 1.03, p = 0.3494).
- Additionally, bilateral mastectomy did not significantly associate with hazard of death (HR 0.98, p = 0.763).